OBJECTIVES: We describe initial human experience with a novel cerebral embolic protection device. BACKGROUND: Cerebral emboli are the major cause of procedural stroke during percutaneous aortic valve interventions. METHODS: With right radial artery access, the embolic protection device is advanced into the aortic arch. Once deployed a porous membrane shields the brachiocephalic trunk and the left carotid artery deflecting emboli away from the cerebral circulation. Embolic material is not contained or removed by the device. The device was used in 4 patients (mean age 90 years) with severe aortic stenosis undergoing aortic balloon valvuloplasty (n = 1) or transcatheter aortic valve implantation (n = 3). RESULTS: Correct placement of the embolic protection device was achieved without difficulty in all patients. Continuous brachiocephalic and aortic pressure monitoring documented equal pressures without evidence of obstruction to cerebral perfusion. Additional procedural time due to the use of the device was 13 min (interquartile range: 12 to 16 min). There were no procedural complications. Pre-discharge cerebral magnetic resonance imaging found no new defects in any of 3 patients undergoing transcatheter aortic valve implantation and a new 5-mm acute cortical infarct in 1 asymptomatic patient after balloon valvuloplasty alone. No patient developed new neurological symptoms or clinical findings of stroke. CONCLUSIONS: Embolic protection during transcatheter aortic valve intervention seems feasible and might have the potential to reduce the risk of cerebral embolism and stroke.
OBJECTIVES: We describe initial human experience with a novel cerebral embolic protection device. BACKGROUND: Cerebral emboli are the major cause of procedural stroke during percutaneous aortic valve interventions. METHODS: With right radial artery access, the embolic protection device is advanced into the aortic arch. Once deployed a porous membrane shields the brachiocephalic trunk and the left carotid artery deflecting emboli away from the cerebral circulation. Embolic material is not contained or removed by the device. The device was used in 4 patients (mean age 90 years) with severe aortic stenosis undergoing aortic balloon valvuloplasty (n = 1) or transcatheter aortic valve implantation (n = 3). RESULTS: Correct placement of the embolic protection device was achieved without difficulty in all patients. Continuous brachiocephalic and aortic pressure monitoring documented equal pressures without evidence of obstruction to cerebral perfusion. Additional procedural time due to the use of the device was 13 min (interquartile range: 12 to 16 min). There were no procedural complications. Pre-discharge cerebral magnetic resonance imaging found no new defects in any of 3 patients undergoing transcatheter aortic valve implantation and a new 5-mm acute cortical infarct in 1 asymptomatic patient after balloon valvuloplasty alone. No patient developed new neurological symptoms or clinical findings of stroke. CONCLUSIONS:Embolic protection during transcatheter aortic valve intervention seems feasible and might have the potential to reduce the risk of cerebral embolism and stroke.
Authors: Pablo Salinas; Raúl Moreno; Luis Calvo; Santiago Jiménez-Valero; Guillermo Galeote; Angel Sánchez-Recalde; Teresa López-Fernández; Sergio Garcia-Blas; Diego Iglesias; Luis Riera; Isidro Moreno-Gómez; Jose María Mesa; Ignacio Plaza; Rocio Ayala; Rosa Gonzalez; José-Luis López-Sendón Journal: World J Cardiol Date: 2012-01-26
Authors: Jochen Reinöhl; Constantin von Zur Mühlen; Martin Moser; Stefan Sorg; Christoph Bode; Manfred Zehender Journal: J Thromb Thrombolysis Date: 2013-05 Impact factor: 2.300